Remote Healthcare Compliance Analyst – FWA & Audits

Integra Partners; Phoenix (AZ); A distancia; USD 77.000 - 94.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Competitive compensation and annualbon

401(k) retirement program with company

Company-paid life insurance

Company-paid short term disability

Medical, Vision, and Dental benefits

Paid Time Off (PTO)

Paid Parental Leave

Sick Time

Holidays and floating holidays

Quarterly events

Health and wellness programs

Career development opportunities

Descripción de la vacante

Integra Partners is seeking a Compliance Analyst to join its Legal team to monitor FWA issues and audit provider billing and UM auth practices. You will research providers, review CMS alerts, and manage compliance risk for the DMEPOS sector.

Requirements include a Bachelor’s degree and at least three years’ SIU or healthcare compliance experience, with strong Excel and data analysis skills; Tableau is a plus. Remote opportunities are available across multiple states.

Formación

• Bachelor’s degree required.
• At least three years’ experience in Special Investigation Unit processes or similar roles; healthcare experience required, DMEPOS experience preferred.
• Strong understanding of fraud waste and abuse issues, healthcare credentialing, medical billing, HIPAA, and related legislation
• Experience with data analysis and excellent user of Excel. Experience with Tableau a plus.
• Strong attention to detail and able to interpret and communicate complex information
• Effective written and verbal communication skills
• Working knowledge of medical billing processes
• Excellent organizational skills, ability to manage multiple projects at once, follow through, and meet tight deadlines.
• A commitment to provide high quality client service and a strong desire to build trusted advisor relationships with key clients and executives.
• Ability to manage and handle sensitive and confidential information with the highest levels of integrity, ethical standards, discretion, and sound judgment.

Responsabilidades

• Conduct audits of vendors and healthcare providers in support of our FWA monitoring processes.
• Run the Fraud, Waste, and Abuse investigation processes.
• Support the administration of the company’s Corporate Compliance program.
• Assign and monitor compliance training and keep detailed, auditable records.
• Collaborate with credentialing, quality assurance, and network management teams to address concerns and implement changes.
• Partner with health plan customers on audits of our business, draft and track audit processes and responses.
• Investigate compliance concerns and issues internally and externally.
• Ensure licensing and other filings with state agencies are up to date.
• Conduct Security Risk Assessments and present results to the compliance committee.
• Work closely with data security staff to address security issues.

Conocimientos

FWA monitoring

Audits

Compliance program

Data analysis

Excel

Tableau

HIPAA

Communication

Organizational skills

Integrity

Educación

Bachelor’s degree

Herramientas

Excel

Tableau

Descripción del empleo

Integra Partners is seeking a Compliance Analyst to join its Legal team to monitor FWA issues and audit provider billing and UM auth practices. You will research providers, review CMS alerts, and manage compliance risk for the DMEPOS sector.

Requirements include a Bachelor’s degree and at least three years’ SIU or healthcare compliance experience, with strong Excel and data analysis skills; Tableau is a plus. Remote opportunities are available across multiple states.